, Kim, , Jeong, , Shin, , Shin, , Shin, , Kim, , Kim, , Uh, , and Ryoo: Antimicrobial Resistance Patterns of Acinetobacter baumannii and Pseudomonas aeruginosa Isolated From Vulnerable Patients in Korea, 2021

Antimicrobial Resistance Patterns of Acinetobacter baumannii and Pseudomonas aeruginosa Isolated From Vulnerable Patients in Korea, 2021

Young Ah Kim1*,  Seok Hoon Jeong2,3,  Jong Hee Shin4,  Kyeong Seob Shin5,  Jeong Hwan Shin6,  Young Ree Kim7,  Hyun Soo Kim8,  Young Uh9,  Nam Hee Ryoo10

1Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
2Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
3Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
4Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
5Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
6Department of Laboratory Medicine and Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Korea
7Department of Laboratory Medicine, Jeju National University College of Medicine, Jeju, Korea
8Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
9Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
10Keimyung University School of Medicine, Daegu, Korea


*Corresponding author: E-mail: yakim@nhimc.or.kr

December 2022
The Annals of Clinical Microbiology 2022 25(4):145-153
Received Date: 16 September 2022
Revised Date: 15 November 2022
Accepted Date: 29 November 2022
DOI: 10.5145/ACM.2022.25.4.4

Citation

ABSTRACT

Background: We compared the antimicrobial resistance rates (AMRs) of major glucose non-fermenting gram-negative bacilli, Acinetobacter baumannii and Pseudomonas aeruginosa, under different clinical conditions. The purpose of the study was to provide useful background data to set up infection control strategies for infection-vulnerable patients.

Methods: The AMRs of blood isolates were compared in various clinical conditions, using data from the Antimicrobial Resistance Surveillance System in Korea.

Results: A. baumannii blood isolates from patients with healthcare-associated infections, inpatients, or intensive care unit (ICU)-admitted patients consistently exhibited higher AMRs to most antimicrobials, except minocycline, tigecycline, and colistin, compared with those from patients with community-acquired infections, outpatients, or non-ICU-admitted patients, respectively. P. aeruginosa blood isolates from patients with healthcare-associated infections showed higher AMRs to most antimicrobials, except ceftazidime and aztreonam, compared with those from patients with community-acquired infections, but not compared to those from inpatients or ICU-admitted patients.

Conclusion: Higher AMRs were associated with A. baumannii bloodstream infections under various clinical conditions, such as healthcare-associated infections and infections in inpatients and ICU-admitted patients. Considering the high AMRs and the limited number of treatment options of A. baumannii, vigorous efforts should be used to prevent the spreading of A. baumannii infections in patients with vulnerable conditions.

Keywords

Antimicrobial resistance rate, Acinetobacter baumannii, Pseudomonas aeruginosa

Figures & Tables

Table 1. Comparison of antimicrobial resistance rates of Acinetobacter baumannii blood isolates in groups

ANTI

CA

(n = 31)

HA

(n = 198)

P-value

Non-ICU

(n = 97)

ICU

(n = 132)

P-value

Inpatient

(n = 206)

Outpatient

(n = 23)

P-value

No.

(%)

No.

(%)

No.

(%)

No.

(%)

No.

(%)

No.

(%)

PIP

< 0.0001

< 0.0001

< 0.0001

S or I

13

(41.94)

15

(7.58)

24

(24.74)

4

(3.03)

18

(8.74)

10

(43.48)

R

18

(58.06)

183

(92.42)

73

(75.26)

128

(96.97)

188

(91.26)

13

(56.52)

SAM

0.0932

0.0009

0.0007

S or I

17

(54.84)

77

(38.89)

52

(53.61)

42

(31.82)

77

(37.38)

17

(73.91)

R

14

(45.16)

121

(61.11)

45

(46.39)

90

(68.18)

129

(62.62)

6

(26.09)

TZP

< 0.0001

< 0.0001

< 0.0001

S or I

13

(41.94)

15

(7.58)

24

(24.74)

4

(3.03)

18

(8.74)

10

(43.48)

R

18

(58.06)

183

(92.42)

73

(75.26)

128

(96.97)

188

(91.26)

13

(56.52)

CAZ

< 0.0001

< 0.0001

0.0002

S or I

13

(41.94)

18

(9.09)

27

(27.84)

4

(3.03)

21

(10.19)

10

(43.48)

R

18

(58.06)

180

(90.91)

70

(72.16)

128

(96.97)

185

(89.81)

13

(56.52)

FEP

< 0.0001

< 0.0001

< 0.0001

S or I

13

(41.94)

20

(10.10)

26

(26.80)

7

(5.3)

22

(10.68)

11

(47.83)

R

18

(58.06)

178

(89.90)

71

(73.20)

125

(94.7)

184

(89.32)

12

(52.17)

IPM

< 0.0001

< 0.0001

0.0004

S or I

12

(38.71)

16

(8.08)

24

(24.74)

4

(3.03)

19

(9.22)

9

(39.13)

R

19

(61.29)

182

(91.92)

73

(75.26)

128

(96.97)

187

(90.78)

14

(60.87)

MEM

< 0.0001

< 0.0001

< 0.0001

S or I

13

(41.94)

16

(8.08)

25

(25.77)

4

(3.03)

19

(9.22)

10

(43.48)

R

18

(58.06)

182

(91.92)

72

(74.23)

128

(96.97)

187

(90.78)

13

(56.52)

AMK

< 0.0001

< 0.0001

< 0.0001

S or I

17

(54.84)

33

(16.67)

39

(40.21)

11

(8.33)

36

(17.48)

14

(60.87)

R

14

(45.16)

165

(83.33)

58

(59.79)

121

(91.67)

170

(82.52)

9

(39.13)

GEN

< 0.0001

< 0.0001

0.0004

S or I

15

(48.39)

25

(12.63)

33

(34.02)

7

(5.3)

29

(14.08)

11

(47.83)

R

16

(51.61)

173

(87.37)

64

(65.98)

125

(94.7)

177

(85.92)

12

(52.17)

TOB

< 0.0001

< 0.0001

< 0.0001

S or I

16

(51.61)

32

(16.16)

39

(40.21)

9

(6.82)

35

(16.99)

13

(56.52)

R

15

(48.39)

166

(83.84)

58

(59.79)

123

(93.18)

171

(83.01)

10

(43.48)

CIP

< 0.0001

< 0.0001

0.0002

S or I

12

(38.71)

14

(7.07)

22

(22.68)

4

(3.03)

17

(8.25)

9

(39.13)

R

19

(61.29)

184

(92.93)

75

(77.32)

128

(96.97)

189

(91.75)

14

(60.87)

MIN

> 0.9999

> 0.9999

> 0.9999

S or I

31

(100.00)

196

(98.99)

96

(98.97)

131

(99.24)

204

(99.03)

23

(100.00)

R

-

0

2

(1.01)

1

(1.03)

1

(0.76)

2

(0.97)

-

0

TGC

0.5474

0.3123

0.3264

S or I

29

(93.55)

173

(87.37)

88

(90.72)

114

(86.36)

183

(88.83)

19

(82.61)

R

2

(6.45)

25

(12.63)

9

(9.28)

18

(13.64)

23

(11.17)

4

(17.39)

CST

> 0.9999

> 0.9999

> 0.9999

S or I

31

(100.00)

196

(98.99)

96

(98.97)

131

(99.24)

204

(99.03)

23

(100.00)

R

-

0

2

(1.01)

1

(1.03)

1

(0.76)

2

(0.97)

-

0

Bold form: statistically significant.

Abbreviations: ANTI, antimicrobials; CA, community-acquired infection; HA, healthcare-associated infection; ICU, intensive care unit; PIP, piperacillin; SAM, ampicillin-sulbactam; TZP, piperacillin-tazobactam; CAZ, ceftazidime; FEP, cefepime; IPM, imipenem; MEM, meropenem; AMK, amikacin; GEN, gentamicin; TOB, tobramycin; CIP, ciprofloxacin; MIN, minocycline; TGC, tigecycline; CST, colistin; S, susceptible; I, intermediate; R, resistant.